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Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis.

Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Gastroenterology, Hepatology and Nutrition, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Immunology, University of Toronto, Toronto, ON, Canada. Electronic address: boyan.tsankov@mail.utoronto.ca. Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Gastroenterology, Hepatology and Nutrition, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada. Electronic address: jallaire@bcchr.ca. BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada. Electronic address: Mike.Irvine@bcchr.ca. Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Infectious Diseases, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada. Electronic address: alison.lopez@cw.bc.ca. Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Infectious Diseases, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada. Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Gastroenterology, Hepatology and Nutrition, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada. Electronic address: bvallance@cw.bc.ca. Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Gastroenterology, Hepatology and Nutrition, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada. Electronic address: kjacobson@cw.bc.ca.

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021;:246-256
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Abstract

OBJECTIVE There is limited information on the severity of COVID-19 infection in children with comorbidities. We investigated the effects of pediatric comorbidities on COVID-19 severity by means of a systematic review and meta-analysis of published literature. METHODS PubMed, Embase, and Medline databases were searched for publications on pediatric COVID-19 infections published January 1st to October 5th, 2020. Articles describing at least one child with and without comorbidities, COVID-19 infection, and reported outcomes were included. RESULTS 42 studies containing 275,661 children without comorbidities and 9,353 children with comorbidities were included. Severe COVID-19 was present in 5.1% of children with comorbidities, and in 0.2% without comorbidities. Random-effects analysis revealed a higher risk of severe COVID-19 among children with comorbidities than for healthy children; relative risk ratio 1.79 (95% CI 1.27 - 2.51; I2 = 94%). Children with underlying conditions also had a higher risk of COVID-19-associated mortality; relative risk ratio 2.81 (95% CI 1.31 - 6.02; I2 = 82%). Children with obesity had a relative risk ratio of 2.87 (95% CI 1.16 - 7.07; I2 = 36%). CONCLUSIONS Children with comorbidities have a higher risk of severe COVID-19 and associated mortality than children without underlying disease. Additional studies are required to further evaluate this relationship.

Methodological quality

Publication Type : Meta-Analysis

Metadata

MeSH terms : COVID-19